In his remarks on opening day of the Colorado State legislature, Gov. Jared Polis was right in calling for the state to, “take additional steps to save money on prescription drugs,” and to, “expand prescription drug discounts to better serve our most vulnerable.” But, perhaps wrong on the how.

That’s why I am asking legislators to demand more transparency from hospitals that participate in the 340B program and demand a fix at the federal level before trying to expand the program in Colorado.

I support preserving the 340B Drug Pricing Program because it twice saved my fiancé’s life — once in 2017 and again in 2025. In 2017, after two decades without needing a doctor, he was suddenly diagnosed with congestive heart failure. In 2025, after losing Medicaid and then his job just before his new insurance took effect, a severe thyroid condition put his life at risk. Both times, 340B ensured he had access to the medications he needed until he could regain Medicaid coverage, proving its vital role in protecting during medical and financial crises.

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For background, the 340B program started 30 years ago as a program through which pharmaceutical manufacturers sold medicines to hospitals and safety-net providers who served our country’s most vulnerable populations economically disadvantaged as well as rural populations — at a steep discount.

Sounds like a great idea, right? Except recently the program ballooned out of control and turned into a hospital markup program that charges patients up to eight times, or more, the hospital cost for drugs. The New York Times recently reported on a cancer patient from Santa Fe, New Mexico, whose insurance was billed $22,700 for medicine the hospital paid just $2,700 to acquire through the 340B program.

This example is not an exception. Policymakers need to step up and investigate how much Colorado hospitals are marking up medicines and — importantly — who is benefiting from those profits?

Sadly, the money is not going to programs to help low-income and uninsured patients access the care they need in the communities where they reside. To be sure, there are some hospitals and clinics doing the right thing with 340B revenues. The legislature can help clean up the bad actors while supporting the good actors in our communities by demanding transparency for how the funds are used.

Unfortunately, the opposite has happened with the introduction of SB25-71. This bill would allow hospitals to continue their unchecked greed without any meaningful transparency or reforms to ensure the 340B program benefits the patients it was intended to serve.

When hospitals charge patients more for their medicines than they pay that isn’t fair. And, when patients and insurance companies are overcharged, we all pay the price in higher premiums — another priority of the Polis administration. As the second-largest drug program ($66 billion in 2023) behind Medicare Part D, it affects all sectors of health care.

Equally as relevant today, as the legislature is looking for ways to make ends meet, hospital abuse of this program actually eats away at Colorado’s budget as an employer.

A recent study from the North Carolina Treasurer found 340B hospitals were marking up the price of oncology medicines for state employees an average of 5.4 times their acquisition cost. How much are Colorado state employees, teachers and taxpayers being overcharged?

If Gov. Polis is serious about expanding access to prescription medicines for vulnerable patients — and I believe he is — he must hold 340B hospitals and clinics accountable for their greedy behavior. It’s time to know where the money is going and hold hospitals and clinics that abuse this program, profiting at the expense of all Coloradans, accountable.

Autumn Brooks is a passionate social justice, education and housing advocate based in Clear Creek County. Through her leadership in the Five Star Neighborhood Collaborative, she empowers residents to understand their rights and organize effectively within their communities.